It’s a common misconception that food is the number one trigger for upticks in digestive symptoms and IBS flares. In fact, anxiety, lack of sleep, and the inability to manage stress all play a role in the frequency and duration of digestive symptoms for those with functional digestive disorders. It’s also the nature of the disease; there is no cure for Irritable Bowel Syndrome so flares will always be an issue, but managing anxiety, stress, and sleep habits can help to minimize the duration and intensity of a flare.
I’ve helped hundreds of clients with digestive disorders and the most common co-occurrence is anxiety; anxiety associated with eating and impending pain, anxiety around urgency to find a bathroom, anxiety from past diet rules that conflict with the Low-FODMAP diet, and anxiety associated with the unexpected and irregular appearance of their bloated bellies.
Now, much of our anxiety stems from the current health crisis facing our world. While there is not much within our control (besides washing hands, social distancing, and staying home when you can), we can work to manage our IBS symptoms and ease our anxiety through diet, sleep, and stress management.
Diet
The most researched dietary intervention currently showing the highest rate of effectiveness is the low-FODMAP diet. The low-FODMAP diet removes all fermentable carbohydrates from the diet for the elimination phase and then systematically adds them back to determine an individual’s trigger foods. If you have worked through the low-FODMAP diet and determined your food triggers, those will be the only foods you need to avoid. If it eases your anxiety, you can go back to the elimination phase for a day or two while you are experiencing a flare. If you tried the low-FODMAP diet with a Registered Dietitian and you were among the small percent for whom it does not work, then food is not your trigger and you do not need to limit your intake.
Sleep
Sleep disturbances are common for people with IBS. They are also common for people who are experiencing stress and anxiety. These disturbances can lead to an exacerbation of symptoms the following day including IBS-related pain and distress. Research has also shown that the disturbances can go beyond the gut to impact mood and increase pain levels. There are a number of ways you can work towards a better nights’ sleep:
- Get to bed at a reasonable hour. This may seem obvious, but making sleep a priority means allowing for at least eight hours of shut-eye before your alarm rings in the morning. This is important even when you are stuck at home.
- Reduce brain stimuli an hour before bedtime. Turn off your screens, lower the lights, and get comfortable. Consider some light reading or a sleepy guided meditation. I like Insight Timer, a free app that contains more than 35,000 meditations including ones that will help you sleep.
- Leave space between eating and bedtime. Two to three hours will give your digestive system time to move food out of your stomach so that you don’t risk acid reflux while lying down in bed. It will also give you the opportunity to empty your bladder before settling down for eight hours.
Stress
Stress is a known contributor to Irritable Bowel Syndrome flares and totally justified during this pandemic. Managing your stress level will help you to keep symptom-induced anxiety at bay and improve your pain levels during a flare. Stress plays two roles: It can make a symptom feel worse and it can trigger an IBS flare on its own. Using self-care activities can help the body and mind relax. Some of these activities include rest, meditation, the use of heating pads, sharing your thoughts with a therapist, and using research-based medications or alternative therapies to minimize symptoms.
The bottom line is this: IBS flares are not your fault; they are the nature of the syndrome. Show yourself some belly love when you need it and know that this too (aka the flare and the pandemic) shall pass.